HomeMy WebLinkAboutMortgage_Grubb°q STAIEMENT OF MORTGAGE OR CONT C� I�DE !�S Coun Township Year
FOR DEDUCTION FROM ASSESSED �U�TIQN � �,J'
saie F«m as�oe �as i zo� �
�' f Prasatbed by DepaM1menl of Loral Go�¢mmenl Fi�nce
FEB 2 3 2009
File Mark
INSTRUCTIONS:
To be filed in person or by mad wRh the CountyAUditor o/ the courrty where the p is lp�'a(�n
Fdmg Dates: i) Real Property: During the 12 rtronths be/we June 77 of lhe year �BQ��don"is ��be e/�ctive.
2) Mo6iie Homes assessed,mder IC 67.7-7: 8ehveen January 15 and Ma��/ fapJj�ibie deduction is to be e8ective.
See reverse side for eddifbnal instrucGons a� qualifications. G�gSON COUN, ' �
, _ _^�L?r.R-�'^•7
/�
P�Y
If rw; .,�1 is his / her ezad share af irrtarest?
If reme an recwA is dRfererq U�ar� thal of appl
Name of mortgagee or
or mnuaA seller (number arM atree4
a hdder of marigage
Address of assgrree (maMei aM sGee4 �1: �afe, and
�oes applicanl own property in arry other
caunty in Indmna7
❑Yes ❑No
appmved in Ne amounl of:
+a�11��'
side)
� - 3Q.3 - GY, _Y. °2,� -a0
MoNgaye � cunbaa indebledness unpaid as ot March 1.
arteMyear . ^ __
yes,
0
someone
�+�
w�t r��y o�s�
COUNTYAUDROR
20 _ I 20 _
Cau�riy
Rem�d rwmber
I �5 I o E
o. e�,�uae wmen
❑ Yes ❑ No
indicate vri�h whom.
Is Ihe pmpaM1y in qucstion:
�eal Property ❑ Mobile Hwne
. � —
_ o aocX� . .... ..
Dl•a����i � �
5�0$ . ... �
��� a ��°3y,�o.�--
n�•R �`
� 20
Dafe (rtonN. day.
I I We cerGfy under ihe penalty of perjury tliat the above and fwegoing infortna6on is We and corred and tha[ tlie applicants was / were a residenl of
1Cdiana and owner of the afwemepponed properly on March 1, 20
�. 6L� "J
auN exear�ea PoNer
Address of author¢ed persan
i_R
sbeel. city. sfate. yfMZlPmde)
state, aM LP mde)
Dale (mmlh. daY. Y��)
�
_ —